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首页> 外文期刊>Cancer Medicine >The value of breast MRI in high-risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?
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The value of breast MRI in high-risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

机译：在对侧预防性乳房切除术中，乳腺MRI在高危新诊断乳腺癌中排除浸润性疾病的价值：明智地选择前哨淋巴结活检的患者是否有作用？

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Abstract The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004?￠????2010) was conducted. Characteristics of patients undergoing CPM with breast MRI obtained less than 6 month before surgery were evaluated. A total of 2322 consecutive patients diagnosed with DCIS or stage I to III infiltrating breast cancer underwent preoperative breast MRI. Of these, 1376 patients (59.2%) had contralateral clinical breast exam and mammography without abnormalities; and 116 patients (4.9%) underwent CPM (28 excluded patients had breast MRI more than 6 months before CPM). The mean age of the 88 patients was 49 years (range 28?￠????76 years). Two (2.3%) DCIS identified on surgical pathology specimen were not depicted by MRI and the 5 mm T1N0 invasive cancer (1.1%) was identified on MRI. Preoperative MRI showed 95% accuracy to demonstrate absence of occult disease with negative predicted value (NPV) of 98% (95% CI: 91.64?￠????99.64%). Occult disease was present in 3.4% of CPM. MRI accurately identified the case of invasive cancer in this cohort. The high negative predictive value suggests that MRI can be used to select patients without consideration of SLNB for the contralateral side.
机译：摘要这项研究的目的是评估在接受对侧预防性乳房切除术（CPM）和腋窝评估（前哨淋巴结活检（SLNB））的癌症患者队列中使用乳腺MRI进行临床和乳房X线隐匿性疾病的存在。侧。回顾性回顾了单侧浸润性乳腺癌或原位导管癌（DCIS）患者的机构MRI登记数据（2004年至2010年）。评估了在手术前不到6个月进行的CPM乳房MRI检查患者的特征。总共2322例被诊断为DCIS或I至III期浸润性乳腺癌的连续患者接受了术前乳房MRI检查。其中，有1376例患者（59.2％）接受了对侧临床乳腺检查和乳房X线检查，未发现异常; 116例患者（4.9％）接受了CPM（28例排除CPM前6个月以上进行乳腺MRI检查的患者）。 88例患者的平均年龄为49岁（28岁〜76岁）。 MRI未描绘出在手术病理标本上识别出的两个（2.3％）DCIS，而在MRI上识别出了5 mm T1N0浸润性癌（1.1％）。术前MRI显示95％的准确度，表明无隐匿性疾病，阴性预测值（NPV）为98％（95％CI：91.64％≥99.64％）。隐性疾病占CPM的3.4％。 MRI准确识别了该队列中的浸润性癌症。高阴性预测值表明，MRI可以用于选择患者，而无需考虑对侧的SLNB。

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